Purpose: To establish an efficient, institutive plan-check process with greater accuracy in the initial plan, and with more time savings.
Methods: Since 2021, we have used a one-click automated plan-check showing failed plan-check items to ensure plan feasibility using the Eclipse Scripting API (version 15.6) in Aria (Varian Medical Systems). This includes the final chart check, treatment plan consistency, and specific-condition miscellanea. The comprehensive plan-check items include: CT simulation date, treatment technique, dose and number of fractions, corresponding machine, CT calibration table, artifact with density-override, jaw relative to MLC position and isocenter location, etc. Miscellanea include: target volume and reference point consistency, tolerance table, FFF mode with the highest dose rate, IMRT MU calculation check, bolus, and gated technique, etc. To evaluate the automated plan-check’s effectiveness, we measured the total processing time with and without scripting on 34 patients. Our department has two recording and verification systems, Aria and MOSAIQ; hence we analyzed error event frequency in both systems. From 2019 to 2021, we tracked scripting's effectiveness.
Results: Using scripting, we found time reductions of 28.55%, 42.73%, 41.98% in 2D, IMRT, and VMAT plan-check processes, respectively. The 2D, IMRT, and VMAT plan average check time were separately reduced from 2 minutes 19 seconds to 1 minute 37 seconds, 4 minutes 41 seconds to 2 minutes 24 seconds, and 3 minutes to 1 minute 40 seconds (Figure1). Between 2019 and 2021, the error event frequency (total error event amount divided by total patient amount) in Aria decreased from 0.641% to 0.405%, and in MOSAIQ from 0.622% to 0.560% (Table1).
Conclusion: Preliminary results indicate that we save approximately 40% time in the plan-check process and decrease the error event frequency. Scripting improves the efficiency of our institutive workflow, and is pivotal for building a smooth electronic workflow in the future.
Treatment Verification, Treatment Planning, Computer Software